31 October 2012 8:40 PM

It is crunch time for clinical common sense in the care of the elderly and the seriously ill.

More elderly people cost the NHS more money. More successful and more expensive treatments cost the NHS more money. Where will this all end - with a bankrupt state or with compulsory euthanasia?

Or is there a third way? The Liberal Democrat health minister, Norman Lamb, believes there is. He wants doctors to draw up a list of patients whom they anticipate will die within one year. He calls this an 'End of life care register'. Some would call it a 'Death list'.

The hope is that many of these patients can be helped to die comfortably and inexpensively at home.

Patients who are over the age of 65 consume over 33% of all healthcare expenditure, much of it in the last year of life and particularly in the last two weeks of their lives if they are in hospital.

But will the Nanny State become ruled by The Dark Angel? Will we have euthanasia by degrees as care considerations gradually become government recommendations and then rules and regulations?

Already the Liverpool Care Pathway gives cause for concern. In this procedure, patients whom doctors believe are inevitably dying are deprived of potentially life-saving treatments, given heavy sedation and deprived of nutrition and fluids. Usually they die within a few days. Is that kindness or cruelty? Or is it a box to be ticked, a hospital bed to be recycled, a cost to be saved?

As a former GP with 45 years of experience, I am familiar with destitution and death.

In addition to having a full list of NHS patients, I was, at one time, the visiting GP to Rowton House in Hammersmith. The Victorian philanthropist, Lord Rowton, built a chain of hostels 'to provide decent accommodation for working men in place of the squalid lodging houses of the time'.

George Orwell, in Down & Out In Paris and London, wrote about lodging houses: ‘The best are the Rowton Houses, where the charge is a shilling, for which you get a cubicle to yourself, and the use of excellent bathrooms.’ I query the word 'excellent' for the bathrooms but there were none on the street where the occupants would otherwise be living.

The problems of caring for the elderly and indigent are not new. I rarely got to know any of the occupants of Rowton House because they tended to stay for only one night or a haphazard series of one nights. My function was simply to give them whatever help and support I could.

It did me no harm at all to see the plight of the genuinely needy. But what good would a much-vaunted 'living will', determining how they wanted their last days to be spent, be to them? The fanciful notions of cosseted politicians have little relevance at the sharp end of clinical practice.

How many people on the Liverpool Care Pathway have the potential to recover? And how would the doctors and nurses know who they are?

And how many people nowadays will not even know that doctors have put their names on an 'End of life care register'?

Whoever designed that concept is a rotten psychologist. It is inevitable that doctors will give less care, and possibly less time and human consideration, to patients whose names are on their 'death list'.

The idea is that patients on this list would be 'less likely to be subject to treatments of limited value'. I fear that 'limited value' is something that doctors might say but patients and their families might dispute.

Doctors and nurses need to use good old-fashioned clinical judgement and concepts of personal consideration. Policies and procedures are no substitute for care and compassion.

Would I myself be worried if my name were on a death list? Yes, I certainly would, whether it be through malign or benign intent. I have no wish to live in the vegetable state to which my father descended three years before his death but I also have no wish to live my final days in the wretched physical circumstances in which my mother lived hers, against my wishes, in a hospital. It would have been better for her to have died at home.

While I have my mental and physical autonomy I want to be my own guide. Without them I have no wish to be a nuisance to anyone else or to block beds and other resources that might more beneficially be used for someone else. I just hope that I shall be treated as more than a number.

I agree very much with the statement of Dr George Vaillant in his book ‘Aging Well’. He says that we should focus upon adding life to our years rather than years to our life.

Share this article:

24 October 2012 7:24 PM

David Cameron is wrong to propose an aspiration society. He should learn from President Reagan, who said that the most frightening words in the English language are 'I'm from the government: I'm here to help'.

Aspiration is fine for individuals but we are impeded by government. Any help given to one able-bodied person hinders another. Any financial support given by government to one company hinders another.Any help given to one industry or one sector of the national economy or one area of the country hinders another.

Entrepreneurs are not a race apart. Everyone has the capacity to be entrepreneurial in some area of life. Making and selling pots of jam, running car boot sales or jumble sales or market stalls and many other enterprising activities are available to anyone. From these humble beginnings great empires can grow - and they do. Except of course that Health and Safety or some code of professional practice or European directive will put a stop to them if they possibly can.

Governments don't like individual initiatives. They want to control them and milk them. The last thing that governments want is for us to do well in our own way. They talk of 'the black economy' and other forms of tax evasion as something evil. Yet what they are really saying is, 'We determine what you should do. We demand the right to take your money under threat of imprisonment'. What sort of morality is that?

When governments talk of 'society' they mean it on their terms. They like private individuals and financiers to bail them out when yet another state-funded project collapses.

The last thing they want is for us to do things in our own way and care for ourselves and others without their help and guidance. We might come to realise that we don't need it.

We can create wealth, which is something that governments can never do. They don't know how and they get it wrong when they try. Then they monitor and control us and they get in our way.

They assume that we would not look after people who are less fortunate than we are. That is profoundly untrue. Many of our top schools and hospitals were originally charitable foundations.

Even today many private schools provide financial bursaries to make up for the inadequacies of the state education system.

And NHS hospitals are always on the scrounge, emotionally blackmailing successful individuals and companies to fund them when they lack equipment or services. Yet they present their begging bowls to those who have already paid their taxes.

They play to the donor's vanity by offering some form of personal recognition. But what they are really acknowledging is that the state services, grossly funded as they are, have become so inefficient and bureaucratised that they are not fit for purpose.

No, Mr Cameron, leave society out of this equation. If you want to encourage aspiration, LAISSEZ NOUS FAIRE.

Share this article:

18 October 2012 7:20 PM

Binge drinking is more dangerous than low levels of
regular drinking. This has been found to be true in laboratory rats. It may
also be true in humans.

This recent research, published in the online edition of the journal Proceedings of the
National Academy of Sciences, is fascinating, partly because the researchers
clearly understand alcoholism.

They are not pontificating from ivory towers in
government departments, health authorities, worthy but mindless charities or
two-brained universities. They do not appear to be single-issue fanatics. They
did research that could have relevance to real live human beings right now.

They found that, after only six weeks, ‘binge-drinking’ rats were consuming far more
than those with access to a continuous supply of alcohol.

They also found that, after only a few months, binge-drinking rats showed signs of impairment in brain function
similar to the changes seen in established alcoholic humans.

The research scientists exposed the 'binge drinking' rats
to alcohol for just three days a week. They say that their findings provide an
insight into how the brain adapts to various drinking patterns.

Now here comes the interesting bit:

The researchers found disorders in a small group of brain
neurons, in the prefrontal cortex, which normally act as a brake on emotional
and impulsive behaviour.

In the 'binge drinking' rats, these neurons were
unusually active in the periods in between drinking binges. Also, the more
active these neurons were, the more the rats drank when they next had access to
alcohol.

The lead researcher, Olivier George, of The Scripps
Research Institute in California said: ‘It’s like a lot of things in life that
the brain perceives as good – if it loses access to it, you feel bad, you get
into a negative emotional state, a little bit frustrated, and so you take more
the next time you have access.

‘We suspect that this very early adaptation of the brain
to intermittent alcohol use helps drive the transition from ordinary social
drinking to binge drinking and dependence.’

Yes, yes, he certainly got that right.

Dr George went on to say that tests during ‘dry’
intervals between drinking sessions showed that the 'binge-drinking' rats
scored poorly on memory, and also struggled with emotions.

‘We normally see such changes in the brains of humans or
other animals that are highly dependent on alcohol – but here we found these
changes in the rats after only a few months of intermittent alcohol use.

The negative effect on the rats' brains disappeared if
they were kept off alcohol for two weeks but these damaging effects returned if
the rats drank alcohol again.'

If that isn't proof of the futility of encouraging
alcoholics to try some 'sensible drinking', what is? Clearly for these rats,
and therefore probably for humans, abstinence is the only way forward.

George Koob, of the research institute’s Pearson Center
for Alcoholism and Addiction Research, said: ‘This process would be of
particular concern in adolescents and
young adults, in whom the prefrontal
cortex isn’t even fully developed.’

Indeed so: binge drinking sessions are common in students
and other teenagers and young adults. They see this as fun - but it comes with
a serious long-term price tag.

Now here comes an even more interesting, and potentially
very relevant, finding:

The researchers are investigating the over-production in
the brain of a stress chemical called CRF, which is released by
alcohol-dependent rats – and also probably human alcoholics – during times of
abstinence. CRF generates feelings of anxiety which can be relieved only by
drinking again.

Dr Koob said the latest results suggest that CRF-blocking
drugs could work to prevent alcohol dependence.

No, he loses me there. It sounds good in theory, provided
that we have no fear of the pharmaceutical industry - which, for me, would be a
very dangerous state. There are better ways of preventing a relapse back to
alcohol dependence than through taking any form of mood-altering substance.

The experience of human alcoholics is that they go up the
wall when they are abstinent. The rats appear to do the same.

The preventive treatment that works for humans in the
long term is the Twelve Step programme
of Alcoholics Anonymous. These abstinent
Alcoholics should have no interest in their last drink: it's the prospect of
the consequences of the next one that should worry them. In the meantime, by
working the Twelve Step programme on a daily basis, they should be able to be
content and creative without any form of chemical dependency. They should
discover that, contrary to their previous beliefs, drinking alcohol is not a
vital part of a happy life.

Having learned in a news story last week that mice can
sing to each other, I wonder if we could introduce these poor 'binge drinking'
rats to AA.

Share this article:

15 October 2012 9:33 PM

The UK Drug Policy Commission, a charity whose committee
members are self-appointed but nonetheless distinguished experts, has spent six
years coming to the conclusion that drug taking is simply another 'moderately
selfish' or 'risky' behaviour, similar to gambling or eating junk food.

This analogy by the Commission may unwittingly
underestimate the tragic effects of compulsive gambling and the influence of
sugar and refined carbohydrates on eating disorders. On that basis, they should
be very concerned indeed over drug use.

They recommend that people should take drugs
'responsibly'. If addicts could do that, they would have done so.

People with a possibly genetically inherited tendency to
addiction need to be distinguished from casual users. For example, it would be
as misguided to assume that alcoholics can learn to drink sensibly as it would
be to say that all drinkers are alcoholics. The same principle applies to drug
users or gamblers or eating disorder sufferers.

The Commission suggests that it should not be a criminal
offence to grow cannabis for personal use.

They are correct in observing that banning drugs has not
reduced their availability and that taking drugs does not always cause
problems.

They are on shakier ground when they say that their
proposed legalisation would undermine the illegal market. They seem not to know
that illegal production of mood-altering substances often continues alongside
legal use. If drug use is legalised, the producers will inflate the amount said
to be for personal use and the government, inevitably, will want to tax it. The
illegal market in nicotine is now very significant.

I am a libertarian politically but there is no liberty in
addiction. Therefore we have to find ways of ensuring that we can distinguish
casual users from the 10 -15% of the population who have addictive tendencies.
These are the people who occupy 20% of all hospital beds and comprise 50% of
all people seen in A + E departments in the evenings and at weekends. The
medical and social, as well as financial, costs of addiction are vast.

Keeping drug use illegal should have the advantage, if
the law is enforced, of ensuring that
recurrent offenders - who are most
likely to be addicts -will discover that continuing use becomes progressively
more painful. This makes it more likely that they will seek help for an
addiction problem that they themselves, as part of the psychopathology of
addiction, don't believe exists.

Cannabis is a dangerous drug. So are many other
'recreational' drugs. So is alcohol. So is nicotine. So is sugar. Yet the law
treats them all differently - because the law is "a ass, a idiot".

But making logical changes to the law would make it totally impossible to
enforce. Therefore we have to maintain an illogical situation in order to get
the best medical, social and financial result.

We should not fool ourselves into believing that cannabis
is harmless. It is dangerous in its own right, let alone as a gateway -
alongside alcohol and nicotine and many other mood-altering substances -
towards other drug use.

Cannabis damages mood, memory and motivation. Do the
members of the UK Drug Policy Commission have any idea of the meaning of the
term 'Pot Head'? If they don't, they are not as wise as they may think they are
on this particular subject.

Share this article:

12 October 2012 7:34 PM

'Patients are more frightened of losing their minds than they are of developing cancer or having a heart attack. I remember a former patient of mine saying, 'thank God it's only cancer. I thought I was going mad'.

A spokesman for the Alzheimer's Society said recently: 'This is not the time to back away from dementia research. Despite dementia costing the economy more than cancer and heart disease, funding for research into dementia is only a fraction of these conditions. More funding is urgently needed if we are to defeat it.'

As a fan of Terry Pratchett's disc-world novels, it distresses me that his own suffering from Alzheimer's disease will in due course stem his magical creative flow. He campaigns for support for the Alzheimer's Society. He deserves it and so do they. All sufferers from this fearful condition deserve it. Their families, upon whom falls much of the burden of care, deserve it.

I am very much aware that research funds are not limitless. Nor are government funds. But they are often spent on the wrong things.

We pander to welfare recipients, many of whom are perfectly fit, but we neglect those who are least able to care for themselves. That is utterly and totally wrong.

Iain Duncan Smith deserves full support in his determination to reform the huge welfare budget. Those who need the most help, and have a chance of benefitting from it, should get it. Skivers and scroungers and benefit tourists who appeal to The European Court of Human Rights should not.

The money to help research into Alzheimer's disease is already in the hands of our government ministers. Shame on them for not recognising this as a prime priority.

Share this article:

09 October 2012 8:02 PM

Marxism is a shallow belief system but deep dangers go with it. The basic tenet, 'from each according to his ability; to each according to his need', is a blueprint for a totalitarian state, not a compassionate society. It imprisons givers and sanctifies takers.

In this respect, David Cameron and Nick Clegg are closet Marxists. Ed Milliband is simply more open about acknowledging the roots of his political philosophy.

Nick Clegg has been pilloried by his own party for reneging on a promise that he made but couldn't keep.

Instead of heading a minority administration, David Cameron tries to detoxify the Conservative brand by making it progressively more socialist. He formed a coalition with people who make unnatural bedfellows.

The Communist Manifesto attracts those who want to take. Either they want something for themselves, at someone else's expense, or they want the credit for giving it to other people.

They profess that they seek power not for themselves but for the benefit of others. But, in practice, they themselves revel in the exercise and trappings of state power.

Politicians are elected on their promises to confiscate and donate. 'Pre-distribution' is just yet another euphemism for legalised theft.

Votes are given on the estimate of whether an individual reckons that he or she is likely to gain or lose in a reapportioning process. Political tracts are fashioned in the guise of altruism but self-interest is the underlying principle.

'To each according to his need' is universal in its appeal. We can all point to our needs, relative to the privilege of some other people. Wants very quickly become needs and then entitlements.

'From each according to his ability' is equally popular when we are looking up the ladder to those whose talents we believe should be channelled towards our betterment.

However, we may fail to note those below us who want - and even demand - that we should give to them.

In this way, any achievement or possession becomes a liability.

This is where the politics of envy, spite and malice has its roots.

In a democracy, the politicians control the military and, to a large extent, the constitutional monarchy. The judiciary remain independent.

In a dictatorship, leadership is taken by force and imposed.

In a theocracy, religious leaders claim civic as well as spiritual power.

That all looks clear cut. But it isn't. The body politic is fluid, not static. Once in power, politicians develop a conceit that in time makes the progression from welfare state to totalitarian state inevitable.

The electorate colludes with this when it demands repeatedly that the government ought to do something over this or that or everything.

Ultimately we get the government and the political system that we deserve. If we want a government to do something, it will. Then, when we wonder where our freedom went, we should recognise that we have only ourselves to blame for throwing it away.

We should challenge the ideas and principles upon which politicians base their manifestos. If we unthinkingly surrender moral right to the likes of The Communist Manifesto, it is only a matter of time before the tanks roll into our streets or until we are expected to spy on each other.

The only protection against this fearful scenario is that we should demand less government locally, nationally and supra-nationally. We need the protection of a minimum state to guarantee the upholding of contract law, the provision of a police force so that we do not have to take the law into our own hands, and defence forces to protect us from foreign invasion. Beyond that, for our own safety, we should care for ourselves and each other without recourse to government. Otherwise the Marxists and Fascists, the two feet of totalitarianism, will walk through an open door.

Share this article:

07 October 2012 8:12 PM

A study of 2,000 people by the healthcare group Benenden found that 70% of us think that our current lifestyle will have a severe impact in old age, 17% will be happy just to reach the age of 70 and only 25%want to live to 100.

This is remarkably negative and pessimistic.

There are ten simple ways towards living a long and happy life:

1. Be lucky.2. Choose your parents carefully. 3. Get a university education.4. Develop one long-term close relationship.5. Enjoy your work, or whatever else you do, as best you can and drop whatever you don't enjoy. 6. Have wide interests.7. Do things that are good for you.8. Avoid things that are bad for you.9. Have a huge amount of fun.10. Learn how to cope well in adversity.

Clearly these are not all achievable by everybody, particularly not in straightened economic times. But that underlines the importance of doing those things that are within individual control.

As a doctor, I was very privileged to be able to learn from observing my patients in widely differing social and economic strata. Irrespective of social circumstances, positive people generally lived long and happy lives whereas negative people did not.

'Aging well', by George Vaillant, is a fascinating book that recounts fifty years of a Harvard University study.

A vast amount of data, about family and social backgrounds and current behaviour, was collected from people in their twenties.

Every ten years they were followed up in personal face-to-face interviews.

Recently these people reached their seventies. Very clear patterns have emerged:

Social class, wealth and childhood upbringing and experiences are not as significant in the long term as educational achievement.

What makes a huge difference, in enduring health and happiness, is the positive or negative attitude that people take into life.

Doctors can do only so much in warning people about the risks they take, giving preventive measures such as inoculations, diagnosing and treating.

And responsible governments are limited in what they tell the electorate can be achieved within a reasonable budget that would not bankrupt the entire country.

Public health measures, such as providing a pure water supply, an effective sanitation system and central heating to remove damp, are very effective.

But ultimately the acquisition and maintenance of health are largely up to each and every one of us.

The Black report on inequalities in health, published in 1980, showed an improvement in health across social classes during the first 35 years of the National Health Service.

However, there was still a significant correlation between social class (as measured by the old Registrar General’s scale) and infant mortality rates, life expectancy and inequalities in the use of medical services.

The Black report received huge publicity and was used as a political battering ram against social class divisions and in favour of the NHS.

But it failed to take sufficient account of one very highly significant factor: lifestyle choices. People in Social Class V smoked more cigarettes, ate more fatty foods and exercised less.

They still do. The social class gradients for inequalities in health persist today largely for the same reasons. A recent report by The King's Fund medical think-tank confirms this.

But our much vaunted NHS, after a further 30 years, fails to compete favourably with other developed countries in outcome of treatment for cancer and many other significant medical conditions.

Our state system of healthcare cannot be relied upon. The NHS is not the envy of the world. For what it costs, it is a disaster. Therefore, if we want to age well, we have to look after ourselves as best we can.

Aging Well: The Harvard Study.

Since 1937, the study has followed 237 students at Harvard University and 332 socially disadvantaged youths from inner-city Boston through health, disease, and death.

'The study shows that successful aging is not an oxymoron', says George Vaillant '55, professor of psychiatry at Harvard Medical School and director of the study for the past 35 years. 'You can add life to your years instead of just years to your life'.

Vaillant and his colleagues at Harvard University Health Services teased out seven predictors, which are at least partly under personal control, and, if adhered to before age 50, can lead to good physical and mental health at ages 70, 80, and older.

Some of them are old news, things like quitting smoking, exercising regularly, and not abusing alcohol. Others turn out to be surprises. For example, education trumps money and social prestige as a route to health and happiness.

'Despite great differences in parental social class, college-tested intelligence, current income and job status, the health decline of the 25 inner-city men who obtained a college education was no more rapid than of the Harvard College graduates', Vaillant points out.

The six other controllable predictors include alcohol abuse, smoking, marriage stability, exercise, weight, and coping mechanisms.

Uncontrollable factors that affect successful aging include parents' social class, family cohesion, longevity of ancestors, and childhood temperament. However, by age 70, these factors are no longer important. High cholesterol before age 50 also loses importance after a 70th birthday. Physical health at age 50 and major depression remain important throughout life.

Among college men still in good health at 50 were 66 men with fewer than four protective factors. At age 80, 50 of these 66 fell into the categories 'sad and sick' or 'prematurely dead'. Not one man was both happy and well.

In contrast, out of 44 college men who had six or seven controllable factors present, 25 ranked among the happy and well; only one was in the sad and sick catagory. 'The predictive power of the factors under some personal control, was as great for the inner-city men as for Harvard graduates', Vaillant notes.

Share this article:

04 October 2012 7:53 PM

Conservative values traditionally involve looking after our families. We should do so - but only up to the point where our generosity and support begins to undermine their capacity to create their own self-reliance.

Trustafarians often don't see that their inheritance is the kiss of death. They forget the old adage 'Rags to rags in three generations'.

The first generation in a family makes money (goes from rags to riches); the second generation holds or keeps the money; and the third generation squanders or loses the money (and so goes back to rags).

My great great grandfather was a successful businessman. He owned property in the Marble Arch area of London.

Then his son, my great grandfather, ran a large furniture business.
His son, my grandfather, made no attempt to work in the family business or any other.

My father grew up in poverty and, as a clergyman, chose to remain in that state.
My brother and I were well educated and each built our own financial base.

Our children have all done well so far, primarily through their own efforts.
But what of the next generation?

How far should we support them, particularly in these times of financial stringency?

Would we be helping them or harming them by giving them money now or in our wills?

Owning and running a private rehab gave me a great deal of experience in seeing how family trusts and other bequests can seriously damage young lives.

'Easy come; easy go' is a reliable financial maxim.
We hear much about the difficulties of young people finding work and getting on the property ladder. These problems are very real.

The problems of the inherited rich may not seem so parlous but I, for one, am unconvinced by the benefits of their wealth.

Jemima Goldsmith inherited a fortune from her father, James, but seems to have nothing better to do with it than support the execrable Julian Assange in his flight from justice.

I am fully in favour of the ownership of private property and wealth and of the right to hand it on. The alternative of state ownership is an utter curse, as can be seen wherever it is tried.

But I question the wisdom of making life financially easier for subsequent generations in our families. Surely the healthiest starting position for them is to start at the bottom. They will value what they create and earn.

Share this article:

01 October 2012 1:47 AM

The financial abyss, towards which we are all heading inexorably, holds no fears for me personally other than over general civil unrest.

I read the news stories of riots in Greece and Spain, as a consequence of their economies imploding within the Eurozone, and I am concerned over what will happen next.

I anticipate that France, with its financially deluded Socialist president, will soon be in the firing line. And in the UK, under our Conservative/Liberal Democrat coalition, let alone under a future Labour government, we won't be far behind in the stampede towards economic and social oblivion.

Countries are no different from businesses or families: we cannot live indefinitely on borrowed money. We cannot go on spending money that we haven't got. Payback time has arrived. It arrived some time ago but dreamers don't want to wake up to that reality.

Europhiles put the European super-state and its godforsaken currency, the Euro, before all else. The real world is unimpressed.

As our national communities become increasingly divided along political lines, and between the perceived 'haves' and 'have nots', the future is likely to be ugly.

Mere possession of 'wealth', irrespective of how it was obtained, will be seen as an unfair privilege. It will be confiscated, one way or another, by government or taken by force on the streets.

I own nothing of any value. Therefore there is nothing material that anyone can take away from me.

I owe nothing to any institution or individual. Nobody chases me. I'm looking at emptying my bank account and converting it into cash. There isn't much anyway.

My rented studio flat, in which I work, is sufficient for all my needs.

I should like to carry on doing my counselling work but I wouldn't do it if it were to be regulated by the state.

The political world will simply have to get along without me. As far as the grasping politicians are concerned, I'm on strike. I want nothing to do with them. They got us into this mess and they can get us out of it.

Or, better still, they should leave us alone to get on with our own lives, so that we can support and help each other, without their nagging and nannying demands.

The Labour Party conference this week is likely to be strong on class warfare and weak on economic realities.

The Conservative Party conference, the week after, is likely to be led towards electoral annihilation when the leadership distances itself even further from its grass roots in the country.

Meanwhile, those of us who earn our livings are increasingly pressurised into feeling guilty for doing so if we keep the proceeds.

Our politicians, throughout Europe, are taking us to hell in a basket - and they blame and penalise us!

Share this article:

DR ROBERT LEFEVER

Dr Robert Lefever established the very first addiction treatment centre in the UK that offered rehabilitation to eating disorder patients, as well as to those with alcohol or drug problems. He was also the first to treat compulsive gambling, nicotine addiction and workaholism.
He identified 'Compulsive Helping', when people do too much for others and too little for themselves, as an addictive behaviour and he pioneered its treatment.
He has worked with over 5,000 addicts and their families in the last 25 years and, until recently, ran a busy private medical practice in South Kensington.
He has written twenty six books on various aspects of depressive illness and addictive behaviour.
He now provides intensive private one-to-one care for individuals and their families.

He has written twenty six books on various aspects of depressive illness and addictive behaviour.

He now uses his considerable experience to provide intensive private one-to-one care for individuals and their families.